Ante-natal HIV testing: An observational study of HIV test discussion in maternity care

There has been a vociferous call for ante-natal HIV testing but low uptake persists in the UK despite DOH guidelines. The reasons for this are complex, with many studies examining intention, offer and uptake of HIV test but few observing the process to understand the nature of HIV discussion with pregnant women. A field observational study was undertaken where researchers attended 154 ante-natal consultations. These were selected in rotation during ante-natal visits by women at four London hospital based ante-natal clinics. A standardized checklist was utilized to monitor information on HIV. A mean of 1.73 minutes was spent discussing HIV infection and testing during ante-natal consultations which lasted for a mean of 33.1 minutes. Risk factors for HIV were mentioned infrequently. When mentioned they concentrated on sexual behaviour which was raised in 11.7% of the consultations. Potential interventions to reduce vertical transmission were discussed with no more than one in five women and possible adverse implications of HIV testing with fewer than one in ten, the only exception being the implications of a positive diagnosis for the baby. Discussion of interventions was associated with HIV test uptake, but risk discussion was not. The short time spent on discussing HIV testing, combined with paucity of mention of information relevant to pregnancy are issues for concern and probably help to explain the level of uptake in the UK.     

A Bibliographic Survey of the Activities and International Nature of Multiple Criteria Decision Making

One of the fascinating things about multiple criteria decision making (MCDM) is the degree to which the contributions that have built the field have come from all over the world. In this paper the international nature of the authorships of the 1216 refereed journal articles published on MCDM between 1987 and 1992, and the journals in which they have appeared, is examined. Also, an analysis of the 217 books and 31 journal special issues that have been published on MCDM, and 143 conferences that have been held on MCDM since the inception of the field, is similarly conducted. The paper concludes with a conference organizer, author and special issue guest editor index.     

WHERE ARE THE LATINAS?

The inclusion of scholarship about Latinas into psychology courses is considered by answering two questions: (1) How do we evaluate the scholarship that should be included? (2) What factors should be considered for inclusion? To answer the first question on the evaluation of scholarship, six criteria are presented. The factors to be considered for the inclusion of scholarship about Latinas are illustrated in a discussion of three topics that are often presented in introductory psychology courses: identity, gender role socialization, and educational achievement and aspirations. Our discussion questions the validity of the conceptualization of these three topics when Latinas and other ethno-racial groups are excluded and offers evidence of the possibilities for clarification and expansion of theory and knowledge when they are included.     

Personality disorder and violence: making the link through risk formulation

The extant research demonstrates that the combination of personality disorder and violence implies severe dysfunction, poor responsivity to treatment, more serious and persistent violence, and higher recidivism rates. Thus, it comes as no surprise that personality disorder is included in many of the available guidelines for assessing and managing violence. Unsurprisingly, the combination of personality pathology and violence frequently presents the greatest challenge to services, even those in whom violence risk assessment and management practice is established and routine. Conceptual and methodological limitations pervade the literature and a full explanation of the nature of the association between personality pathology and violence is still awaited. Furthermore, current approaches to risk assessment fail to provide a systematic framework for assessors to use to make sense of the heterogeneous presentations typically found in individuals with personality disorder and violence. In this paper, formulation is proposed as the critical process linking risk assessment and risk management. It is argued that assessors must move beyond a simple listing of risk factors and should instead produce detailed, comprehensive, individualized explanations of risk potential and risk management needs. Personality disorder is used in this paper to illustrate the important contribution of formulation to the risk assessment process, and in doing so, the link between personality pathology and violence is explored.     

Investigating semantic memory impairments: The contribution of semantic priming

Abstract

The semantic priming task is a valuable tool in the investigation of semantic memory impairments in patients with acquired disorders of language. This is because priming performance reflects automatic or implicit access to semantic information, unlike most other tests of semantic knowledge, which rely on explicit, voluntary access. Priming results are important for two main reasons: First, normal priming results may be observed in patients who perform poorly on other semantic memory tests, enabling us to distinguish between loss of, or damage to, information in semantic memory, and voluntary access to that information. Second, we can investigate the detailed pattern of loss and preservation of different types of semantic information, by charting the priming effects for different kinds of words, and different kinds of semantic relations between primes and targets.

We discuss the use of the priming task in this context, and address some of the theoretical and methodological criticisms that have been raised in connection with use of the priming task to address these issues. We then describe two recent studies in which we have employed semantic priming tasks, along with other more traditional methods, to investigate specific questions about the semantic memory deficits of three patients.     

Beyond Midlife and Before Retirement: A Short-Term Women’s Group

As women move into the second half of life and towards retirement, they may experience many changes and transitions, including in health, relationships, career choices, and spirituality. Some of those changes can be distressing, such as serious health problems for themselves or their families, increased isolation, multiple losses of important people, feelings of uselessness and lack of a meaningful role, and growing questions or struggles around spirituality. Time is often seen as moving faster and increasingly limited. This short-term group offers an opportunity for women to reflect upon issues of identity, values, choices, desires, and hopes regarding relationships, work and other activities, spirituality, and health to create new visions. We describe an integrated theoretical framework that includes existentialism, mindfulness, adult development, object relations, attachment, and relational cultural therapy. We discuss the group’s underlying assumptions in terms of its short-term and semi-structured nature and its format, and suggest exercises, with examples highlighting important learning and/or group interaction. Finally, we address the need for more intensive psychotherapy, outliers, ensuring participation, and our own responses.     

Ethnic Differences in Substance Use Patterns in a Sample of Pregnant Substance‐Using Women in Treatment

This study investigated substance use patterns among 192 pregnant substance‐using women to assess whether ethnic differences exist regarding drugs of choice, frequency and recency of use, and severity of use. Substance use patterns differed across ethnic groups. Alaska Native women were more likely to choose alcohol as their primary drug of choice and less likely to choose cocaine; White women used a wider variety of substances in their lifetime and used substances more often. Alaska Native women had an earlier age of onset of use and more blackouts. These findings suggest that prevention and intervention efforts have to be tailored to the targeted audience.     

Veracity is in the eye of the beholder: A lens model examination of consistency and deception

Research has attempted to explain perceived cues to deception based upon self-report of what participants believe are ‘good’ cues to deception, or self-report of what cues participants say they base their veracity judgements on. However, it is not clear to what extent participants can accurately self-report what influences their decision-making. Using a within-subjects design, 285 participants completed a questionnaire regarding their beliefs about deception before rating a selection of truthful and deceptive statements on a variety of cues. Expert coders also rated the statements for the same cues. Laypeople and expert coders do not conceptualise between-subject consistency in the same way. A lens model showed that whilst perceptions of cues, such as consistency and amount of detail, influence veracity judgements, these perceptions (and overall veracity judgements) are mostly inaccurate. Fundamentally, there seems to be inconsistencies between how deception research examines consistency and how it is understood and used by laypeople.